Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QS0010X | Family Doctor - Sports Medicine | AT00331 | RI |
N | 207QS0010X | Family Doctor - Sports Medicine | AT441 | ME |
NPI | 1174911630 |
---|---|
Provider Name | Lindsey Anne Laturnau |
First Address | Londonderry, NH 03053-4611 |
Second Address | Providence, RI 02918-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/01/2015 |
Last Update Date | 06/01/2015 |